Antidepressants and heart-rate variability in older adults: a population-based study

2015 ◽  
Vol 46 (6) ◽  
pp. 1239-1247 ◽  
Author(s):  
R. Noordam ◽  
M. E. van den Berg ◽  
M. N. Niemeijer ◽  
N. Aarts ◽  
A. Hofman ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Drug Effect ◽  
Population Based ◽  
Study Cohort ◽  
Rotterdam Study ◽  
Lower Heart Rate ◽  
Population Based Study

BackgroundTricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) may be associated with lower heart rate variability (HRV), a condition associated with increased mortality risk. We aimed to investigate the association between TCAs, SSRIs and HRV in a population-based study.MethodIn the prospective Rotterdam Study cohort, up to five electrocardiograms (ECGs) per participant were recorded (1991–2012). Two HRV variables were studied based on 10-s ECG recordings: standard deviation of normal-to-normal RR intervals (SDNN) and root mean square of successive RR interval differences (RMSSD). We compared the HRV on ECGs recorded during use of antidepressants with the HRV on ECGs recorded during non-use of any antidepressant. Additionally, we analysed the change in HRV on consecutive ECGs. Those who started or stopped using antidepressants before the second ECG were compared with non-users on two ECGs.ResultsWe included 23 647 ECGs from 11 729 participants (59% women, mean age 64.6 years at baseline). Compared to ECGs recorded during non-use of antidepressants (n = 22 971), SDNN and RMSSD were lower in ECGs recorded during use of TCAs (n = 296) and SSRIs (n = 380). Participants who started using TCAs before the second ECG had a decrease in HRV and those who stopped had an increase in HRV compared to consistent non-users (p < 0.001). Starting or stopping SSRIs was not associated with HRV changes.ConclusionTCAs were associated with a lower HRV in all analyses, indicating a real drug effect. For SSRIs the results are mixed, indicating a weaker association, possibly due to other factors.

Antidepressants, autonomic function and mortality in patients with coronary heart disease: data from the Heart and Soul Study

2014 ◽  
Vol 44 (14) ◽  
pp. 2975-2984 ◽  
Author(s):  
F. Zimmermann-Viehoff ◽  
L. K. Kuehl ◽  
H. Danker-Hopfe ◽  
M. A. Whooley ◽  
C. Otte
Keyword(s):  
Heart Rate ◽  
Coronary Heart Disease ◽  
Heart Rate Variability ◽  
Heart Disease ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Autonomic Function ◽  
Control Group ◽  
Observational Period ◽  
Lower Heart Rate

BackgroundAntidepressants reduce depressive symptoms in patients with coronary heart disease, but they may be associated with increased mortality. This study aimed to examine whether the use of tricyclic antidepressants (TCA) or selective serotonin reuptake inhibitors (SSRI) is associated with mortality in patients with coronary heart disease, and to determine whether this association is mediated by autonomic function.MethodA total of 956 patients with coronary heart disease were followed for a mean duration of 7.2 years. Autonomic function was assessed as heart rate variability, and plasma and 24-h urinary norepinephrine.ResultsOf 956 patients, 44 (4.6%) used TCA, 89 (9.3%) used SSRI, and 823 (86.1%) did not use antidepressants. At baseline, TCA users exhibited lower heart rate variability and higher norepinephrine levels compared with SSRI users and antidepressant non-users. At the end of the observational period, 52.3% of the TCA users had died compared with 38.2% in the SSRI group and 37.3% in the control group. The adjusted hazard ratio (HR) for TCA use compared with non-use was 1.74 [95% confidence interval (CI) 1.12–2.69, p = 0.01]. Further adjustment for measures of autonomic function reduced the association between TCA use and mortality (HR = 1.27, 95% CI 0.67–2.43, p = 0.47). SSRI use was not associated with mortality (HR = 1.15, 95% CI 0.81–1.64, p = 0.44).ConclusionsThe use of TCA was associated with increased mortality. This association was at least partially mediated by differences in autonomic function. Our findings suggest that TCA should be avoided in patients with coronary heart disease.

Higher heart rate and reduced heart rate variability persist during sleep in chronic fatigue syndrome: A population-based study

2007 ◽  
Vol 137 (1-2) ◽  
pp. 94-101 ◽  
Author(s):  
Roumiana S. Boneva ◽  
Michael J. Decker ◽  
Elizabeth M. Maloney ◽  
Jin-Mann Lin ◽  
James F. Jones ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Population Based ◽  
Population Based Study ◽  
Fatigue Syndrome

Population-based study of heart rate variability and prevalent myocardial infarction

1996 ◽  
Vol 29 (3) ◽  
pp. 189-198 ◽  
Author(s):  
Duanping Liao ◽  
Gregory W. Evans ◽  
Lloyd E. Chambless ◽  
Ralph W. Barnes ◽  
Paul Sorlie ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Population Based ◽  
Population Based Study

scholarly journals Association of health behaviour with heart rate variability: a population-based study

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Alexander Kluttig ◽  
Barbara Schumann ◽  
Cees A Swenne ◽  
Jan A Kors ◽  
Oliver Kuss ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Health Behaviour ◽  
Population Based ◽  
Population Based Study

scholarly journals Heart rate variability and depressive symptoms: a cross-lagged analysis over a 10-year period in the Whitehall II study

2016 ◽  
Vol 46 (10) ◽  
pp. 2121-2131 ◽  
Author(s):  
V. K. Jandackova ◽  
A. Britton ◽  
M. Malik ◽  
A. Steptoe
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Depressive Symptoms ◽  
General Health Questionnaire ◽  
Antidepressant Medication ◽  
Population Based ◽  
Baseline Heart Rate ◽  
Lower Baseline ◽  
The Uk

BackgroundPeople with depression tend to have lower heart rate variability (HRV), but the temporal sequence is poorly understood. In a sample of the general population, we prospectively examined whether HRV measures predict subsequent depressive symptoms or whether depressive symptoms predict subsequent levels of HRV.MethodData from the fifth (1997–1999) and ninth (2007–2009) phases of the UK Whitehall II longitudinal population-based cohort study were analysed with an average follow-up of 10.5 years. The sample size for the prospective analysis depended on the analysis and ranged from 2334 (644 women) to 2276 (602 women). HRV measures during 5 min of supine rest were obtained. Depressive symptoms were evaluated by four cognitive symptoms of depression from the General Health Questionnaire.ResultsAt follow-up assessment, depressive symptoms were inversely associated with HRV measures independently of antidepressant medication use in men but not in women. Prospectively, lower baseline heart rate and higher HRV measures were associated with a lower likelihood of incident depressive symptoms at follow-up in men without depressive symptoms at baseline. Similar but statistically insignificant associations were found in women. Adjustments for known confounders including sociodemographic and lifestyle factors, cardiometabolic conditions or medication did not change the predictive effect of HRV on incident depressive symptoms at follow-up. Depressive symptoms at baseline were not associated with heart rate or HRV at follow-up in either sex.ConclusionsThese findings are consistent with an aetiological role of the autonomic nervous system in depression onset.

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